Reproductive System Flashcards
- Know the definitions and causes of dysmenorrhea, amenorrhea, and DUB.`
Dysmenorrhea (801) – painful menstruation, due to release of prostaglandins from endometrium (primary) or related to pelvic pathological conditions (e.g., endometriosis) and can occur anytime in cycle (secondary)
Amenorrhea (801) – lack of menstruation. May be normal (pregnancy) or pathological (e.g., genetic disorders such as Turner syndrome)
Dysfunctional uterine bleeding (DUB) - heavy or irregular bleeding in the absence of disease. Usually associated with anovulatory cycles (more common in years just prior to menopause, when ovulation is more sporadic). In this type of cycle, no progesterone is produced, but estrogen continues to be produced. Effect is a very thick endometrium, which produces heavy bleeding.
- Describe endometriosis (definition and 3 facts).
presence of functioning endometrial tissue outside of the uterus (occurs primarily in the abdominal and pelvic cavities.)
not sure of cause
if blood supply is sufficient, the ectopic endometrium follows the same growth/breakdown and bleeding pattern of the endometrium in the uterus.
The bleeding causes inflammation and pain in surrounding tissues. The inflammation may lead to fibrosis, scarring and adhesions.
- What is cervical cancer caused by? Name 3 risk factors.
Cervical (813)
Most common cancer of women, worldwide (not the most common in Canada, due to Pap smear=early detection)
Almost exclusively caused by human papillomavirus (HPV) (specifically, the “high-risk” types)
50% of young women acquire HPV within 3 yrs of initiation of sexual intercourse, however, most are spontaneously cleared by the immune system, and do not progress into cancer.
Risk factors are smoking, immunosuppression, poor nutrition.
Slowly progressive disease – about 90% of cervical cancers can be detected early through the use of Pap and HPV testing.
- What is the primary risk factor for endometrial cancer and what age group is mainly affected?
Endometrial cancer (816)
Most prevalent malignancy of female reproductive tract
Primary risk factor is unopposed estrogen exposure (as in anovulatory cycles) resulting in hyperplasia.
Mostly occurs in post-menopausal women
- What are the risk factors for ovarian cancer, and what is risk reduced by?
- What is one of the reasons why ovarian cancer causes more deaths than any other cancer of the reproductive system?
Ovarian cancer (816)
Causes more deaths than any other cancer of the female reproductive system.
Risk factors: increasing age, family history (breast, ovarian and colon cancers appear to share common genetic markers), frequency of ovulation
Risk is reduced by factors that suppress ovulation
Early stages very difficult to detect (only 20% of ovarian cancers are found in the early stage)
- Describe benign breast disease and give 2 examples of the appearance of benign breast disease.
Noncancerous changes in breast tissue
Irregular lumps, cysts, sensitive nipples and pruritus
- Name and describe the 3 classes of lesions associated with benign breast disease. Which of these is correlated with increases in breast cancer risk?
Nonproliferative breast lesions – e.g., cysts, fluid filled sacs commonly occur in women in their thirties to early fifties. Affected by hormonal changes such as those within menstrual cycle.
. Proliferative breast lesions
Characterized by growth of tissue, without cellular signs of malignancy. E.g., hyperplasia of cells in the ducts (normally two layers (one to secrete milk, one to contract to release milk), can proliferate to four or more layers)
- Proliferative breast lesions with atypia
As above, but there is abnormalities in the structure. E.g., increased number of cells within the lumen of the ducts
- What are two mechanisms in which estrogen is thought to play a part in the development of breast cancer?
- What timing (early/late onset) for menarche and menopause increase the risk for breast cancer?
- What timing for giving birth affects the risk of breast cancer?
Hormonal changes: length of exposure to estrogen and progesterone has been observed to have an effect. Early menarche + late menopause increases the risk. Estrogen is thought to either cause increased cell proliferation, which increases the possibility of accumulating genetic damage, or break down into toxic compounds that can directly damage DNA.
Giving birth at less than 18yrs decreases the risk; at more than 35 yrs increases the risk. More births and breast feeding decreases the risk.
Family history: specific gene mutations (BRCA1 and BRCA2) have been linked with increased risk. Even without these, a mother/sister with breast cancer increases the risk.
Age: risk increases with age
- Name the two genes that have been linked with an increased risk of breast cancer.
BRCA1/2
- Define lobular involution of the breast. How does this process alter the risk of breast cancer?
- What is the “dense” tissue of breast tissue composed of? How does the amount of dense tissue in a woman’s breast affect her risk for breast cancer/
Involution – with age (starting in 30’s), the glandular structures and connective tissue between the glands (stroma) are replaced with fatty tissue. This process is known as lobular involution. The more involution has occurred, the lower the risk of cancer (beginning to think that not just age is a risk factor, but age combined with degree of involution. Increased risk of pregnancy after age of 35 may be interruption and reversal of involution.)
Breast density: related to the above is degree of breast density. The denser the tissue (thought to be both glandular and stroma, appears white on a mammogram), the higher the risk. The more involuted the breast tissue (the fattier), the lower the risk.
- Where do most breast cancers arise in the breast? Describe the sequence of events involving metastasis.
- What is the usual first sign of breast cancer?
Most breast cancers arise from the epithelium of the ducts (79%), but can occur in the lobules or in the stroma.
The edges of the lesion can invade local tissue, which is then followed by malignant cells scattering into the lymph nodes. From there, the cancer can metastasize into other body site, commonly the lung, liver and bone.
First sign is usually a painless lump (usually in upper outer quandrant, where most of the glandular tissue of the breast is located).
- Define urethritis, urethral stricture, cryptorchidism and the causes of the first two terms.
Urethritis (819) – tingling, itching, burning frequent urination: inflammatory process usually caused by sexually transmitted organism. Urethral stricture (819) – narrowing of the urethra caused by scarring (caused by trauma, long term use of in-dwelling catheters, infection) Cryptorchidism (823) – group of abnormalities in which the testis fails to descend completely (may remain in abdomen, or only partially descend).
- Define varicocele and hydrocele.
Varicocele (822) – abnormal dilation of the testicular vein, one of the most commonly identified scrotal abnormalities. Decreases blood flow through the testes, interfering with spermatogenesis.
Hydrocele (823) – collection of fluid between outer layers of tissue surrounding testes – asymptomatic and usually self-resolving.
- Describe torsion of the testis, its causes and what it can lead to.
when the testis rotates on its axis, interrupting its blood supply (can occur with exertion or trauma). Causes ischemia (pain and swelling) – must be corrected with 6 hrs of symptoms to preserve normal function
- Define benign prostatic hyperplasia (hypertrophy).
Enlargement of the prostate gland
Becomes a problem if enlargement interferes with passage of urine through urethra
Normal enlargement that begins around 40-45 yrs of age and continues slowly for remainder of life.
Result of a complex interaction between sex hormones, chronic inflammation and growth factors.
